Skip to main content
SpringerLink
Log in

Child-Report of Family Accommodation in Pediatric Anxiety Disorders: Comparison and Integration with Mother-Report

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

Reducing family accommodation (FA) may be beneficial in cases of childhood anxiety disorders. Assessment of FA has so far relied on single-informant maternal report, which may be biased by factors including maternal anxiety. We compared child and mother reports of FA, and examined whether maternal anxiety moderates the association between mother and child report. Participants were fifty children with primary DSM-5 anxiety disorders, and their mothers. Mother–child agreement was good for overall FA and moderate for subdomains of FA. Mothers reported significantly more FA than children. Maternal anxiety moderated the association between mother and child report of FA, such that the correlation was stronger in more anxious mothers. Children agreed that FA helps them feel less anxious and did not agree that parents should accommodate less. FA is an important clinical characteristic of childhood anxiety disorders and assessment can be enhanced through child report and consideration of maternal anxiety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Costello EJ, Egger HL, Angold A (2005) The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child Adolesc Psychiatr Clin N Am 14:631–648, vii

  2. Compton SN, March JS et al (2004) Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. J Am Acad Child Adolesc Psychiatry 43:930–959

    Article  PubMed  Google Scholar 

  3. Greenberg PE, Sisitsky T et al (1999) The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry 60:427–435

    Article  PubMed  Google Scholar 

  4. Rapee RM, Schniering CA, Hudson JL (2009) Anxiety disorders during childhood and adolescence: origins and treatment. Annu Rev Clin Psychol 5:311–341

    Article  PubMed  Google Scholar 

  5. Ginsburg GS, Becker EM et al (2014) Naturalistic follow-up of youths treated for pediatric anxiety disorders. JAMA Psychiatry 71:310–318

  6. Cobham VE, Dadds MR, Spence SH (1998) The role of parental anxiety in the treatment of childhood anxiety. J Consult Clin Psychol 66:893–905

    Article  PubMed  Google Scholar 

  7. Last CG, Francis G et al (1987) Separation anxiety and school phobia: a comparison using DSM-III criteria. Am J Psychiatry 144:653–657

    Article  PubMed  Google Scholar 

  8. Weissman MM, Leckman JF et al (1984) Depression and anxiety disorders in parents and children. Results from the Yale family study. Arch Gen Psychiatry 41:845–852

    Article  PubMed  Google Scholar 

  9. Beidel DC, Turner SM (1997) At risk for anxiety: I. Psychopathology in the offspring of anxious parents. J Am Acad Child Adolesc Psychiatry 36:918–924

    Article  PubMed  Google Scholar 

  10. Turner SM, Beidel DC, Costello A (1987) Psychopathology in the offspring of anxiety disorders patients. J Consult Clin Psychol 55:229–235

    Article  PubMed  Google Scholar 

  11. Dadds MR, Barrett PM et al (1996) Family process and child anxiety and aggression: an observational analysis. J Abnorm Child Psychol 24:715–734

    Article  PubMed  Google Scholar 

  12. Rapee RM (1997) Potential role of childrearing practices in the development of anxiety and depression. Clin Psychol Rev 17:47–67

    Article  PubMed  Google Scholar 

  13. Ginsburg GS, Siqueland L et al (2004) Anxiety disorders in children: family matters. Cogn Behav Pract 11:28–43

    Article  Google Scholar 

  14. Siqueland L, Kendall PC, Steinberg L (1996) Anxiety in children: perceived family environments and observed family interaction. J Clin Child Psychol 25:225–237

    Article  Google Scholar 

  15. Wood JJ, McLeod BD et al (2003) Parenting and childhood anxiety: theory, empirical findings, and future directions. J Child Psychol Psychiatry 44:134–151

    Article  PubMed  Google Scholar 

  16. Watt MC, Stewart SH, Cox BJ (1998) A retrospective study of the learning history origins of anxiety sensitivity. Behav Res Ther 36:505–525

    Article  PubMed  Google Scholar 

  17. Ehlers A (1993) Somatic symptoms and panic attacks: a retrospective study of learning experiences. Behav Res Ther 31:269–278

    Article  PubMed  Google Scholar 

  18. Breinholst S, Esbjorn BH et al (2012) CBT for the treatment of child anxiety disorders: a review of why parental involvement has not enhanced outcomes. J Anxiety Disord 26:416–424

    Article  PubMed  Google Scholar 

  19. Barmish AJ, Kendall PC (2005) Should parents be co-clients in cognitive-behavioral therapy for anxious youth? J Clin Child Adolesc Psychol 34:569–581

    Article  PubMed  Google Scholar 

  20. Reynolds S, Wilson C et al (2012) Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review. Clin Psychol Rev 32:251–262

    Article  PubMed  Google Scholar 

  21. Silverman WK, Pina AA, Viswesvaran C (2008) Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. J Clin Child Adolesc Psychol 37:105–130

    Article  PubMed  Google Scholar 

  22. Lebowitz ER, Woolston J et al (2013) Family accommodation in pediatric anxiety disorders. Depress Anxiety 30:47–54

    Article  PubMed Central  PubMed  Google Scholar 

  23. Calvocoressi L, Lewis B et al (1995) Family accommodation in obsessive–compulsive disorder. Am J Psychiatry 152:441–443

    Article  PubMed  Google Scholar 

  24. Calvocoressi L, Mazure CM et al (1999) Family accommodation of obsessive–compulsive symptoms: instrument development and assessment of family behavior. J Nerv Ment Dis 187:636–642

    Article  PubMed  Google Scholar 

  25. Lebowitz ER, Panza KE et al (2012) Family accommodation in obsessive–compulsive disorder. Expert Rev Neurother 12:229–238

    Article  PubMed Central  PubMed  Google Scholar 

  26. Storch EA, Geffken GR et al (2007) Family accommodation in pediatric obsessive–compulsive disorder. J Clin Child Adolesc Psychol 36:207–216

    Article  PubMed  Google Scholar 

  27. Garcia AM, Sapyta JJ et al (2010) Predictors and moderators of treatment outcome in the pediatric obsessive compulsive treatment study (POTS I). J Am Acad Child Adolesc Psychiatry 49:1024–1033

    Article  PubMed Central  PubMed  Google Scholar 

  28. Albert U, Bogetto F et al (2010) Family accommodation in obsessive–compulsive disorder: relation to symptom dimensions, clinical and family characteristics. Psychiatry Res 179:204–211

    Article  PubMed  Google Scholar 

  29. Lebowitz ER, Scharfstein LA, Jones J (2014) Comparing family accommodation in pediatric obsessive–compulsive disorder, anxiety disorders, and non-anxious children. Depress Anxiety. doi:10.1002/da.22251

  30. Silverman WK, Kurtines WM (1996) Anxiety and phobic disorders : a pragmatic approach. Clinical child psychology library. Plenum Press, New York, xvi, 142 p

  31. Walkup JT, Albano AM et al (2008) Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 359:2753–2766

    Article  PubMed Central  PubMed  Google Scholar 

  32. Adelman CB, Lebowitz ER (2012) Poor insight in pediatric obsessive compulsive disorder: developmental considerations, treatment implications, and potential strategies for improving insight. J Obsessive Compuls Relat Disorders 1:119

    Article  Google Scholar 

  33. Freeman JB, Garcia AM et al (2003) Family-based treatment of early-onset obsessive–compulsive disorder. J Child Adolesc Psychopharmacol 13:71–80

    Article  Google Scholar 

  34. Merry SN (2011) ‘Timid to Tiger’ group parenting training reduces anxiety diagnoses in 3–9-year-olds. Evid Based Mental Health 14:74

    Article  Google Scholar 

  35. Lebowitz ER, Omer H et al (2013) Parent training for childhood anxiety disorders: The SPACE Program. Cogn Behav Pract. doi:10.1016/j.cbpra.2013.10.004

  36. Lebowitz ER (2013) Parent-based treatment for childhood and adolescent OCD. J Obsessive Compuls Relat Disord 2:425–431

    Article  Google Scholar 

  37. Storch EA, Jones AM et al (2012) Rage attacks in pediatric obsessive–compulsive disorder: phenomenology and clinical correlates. J Am Acad Child Adolesc Psychiatry 51:582–592

    Article  PubMed  Google Scholar 

  38. Stewart SE (2012) Rage takes center stage: focus on an underappreciated aspect of pediatric obsessive–compulsive disorder. J Am Acad Child Adolesc Psychiatry 51:569–571

    Article  PubMed  Google Scholar 

  39. Lebowitz ER, Omer H, Leckman JF (2011) Coercive and disruptive behaviors in pediatric obsessive–compulsive disorder. Depress Anxiety 28:899–905

    Article  PubMed Central  PubMed  Google Scholar 

  40. DiBartolo PM, Albano AM et al (1998) Cross-informant agreement in the assessment of social phobia in youth. J Abnorm Child Psychol 26:213–220

    Article  PubMed  Google Scholar 

  41. Birmaher B, Khetarpal S et al (1997) The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 36:545–553

    Article  PubMed  Google Scholar 

  42. Comer JS, Kendall PC (2004) A symptom-level examination of parent-child agreement in the diagnosis of anxious youths. J Am Acad Child Adolesc Psychiatry 43:878–886

    Article  PubMed  Google Scholar 

  43. Choudhury MS, Pimentel SS, Kendall PC (2003) Childhood anxiety disorders: parent–child (dis)agreement using a structured interview for the DSM-IV. J Am Acad Child Adolesc Psychiatry 42:957–964

    Article  PubMed  Google Scholar 

  44. Grills AE, Ollendick TH (2002) Issues in parent-child agreement: the case of structured diagnostic interviews. Clin Child Fam Psychol Rev 5:57–83

    Article  PubMed  Google Scholar 

  45. Krain AL, Kendall PC (2000) The role of parental emotional distress in parent report of child anxiety. J Clin Child Psychol 29:328–335

    Article  PubMed  Google Scholar 

  46. Briggs-Gowan MJ, Carter AS, Schwab-Stone M (1996) Discrepancies among mother, child, and teacher reports: examining the contributions of maternal depression and anxiety. J Abnorm Child Psychol 24:749–765

  47. Sawyer MG, Sarris A et al (1988) Family assessment device: reports from mothers, fathers, and adolescents in community and clinic families. J Marital Fam Ther 14:287–296

  48. Bogels SM, van Melick M (2004) The relationship between child-report, parent self-report, and partner report of perceived parental rearing behaviors and anxiety in children and parents. Pers Individ Diff 37:1583–1596

  49. Schwarz JC, Barton-Henry ML, Pruzinsky T (1985) Assessing child-rearing behaviors: a comparison of ratings made by mother, father, child, and sibling on the CRPBI. Child Dev 56:478

    Article  Google Scholar 

  50. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington

  51. Silverman WK, Saavedra LM, Pina AA (2001) Test–retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40:937–944

    Article  PubMed  Google Scholar 

  52. Wood JJ, Piacentini JC et al (2002) Concurrent validity of the anxiety disorders section of the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Clin Child Adolesc Psychol 31:335–342

  53. Silverman WK, Kurtines WM et al (1999) Contingency management, self-control, and education support in the treatment of childhood phobic disorders: a randomized clinical trial. J Consult Clin Psychol 67:675–687

    Article  PubMed  Google Scholar 

  54. Silverman WK, Kurtines WM et al (2009) Directionality of change in youth anxiety treatment involving parents: an initial examination. J Consult Clin Psychol 77:474–485

    Article  PubMed Central  PubMed  Google Scholar 

  55. March J (2013) The multidimensional anxiety scale for children 2nd edition—info sheet. MHS 2

  56. March J (1997) The multidimensional anxiety scale for children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry 36:554–565

    Article  PubMed  Google Scholar 

  57. Beck AT, Epstein N et al (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897

    Article  PubMed  Google Scholar 

  58. Aiken LS, West SG (1991) Multiple regression: testing and interpreting interactions. Sage, Thousand Oaks

  59. Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Methodology in the social sciences. The Guilford Press, New York

  60. Bogels SM, van Oosten A et al (2001) Familial correlates of social anxiety in children and adolescents. Behav Res Ther 39:273–287

    Article  PubMed  Google Scholar 

  61. Najman JM, Williams GM et al (2001) Bias influencing maternal reports of child behaviour and emotional state. Soc Psychiatry Psychiatr Epidemiol 36:186–194

Download references

Author information

Authors and Affiliations

  1. Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06520, USA

    Eli R. Lebowitz & Lindsay Scharfstein

  2. University of Texas, Austin, TX, USA

    Johnna Jones

Authors
  1. Eli R. Lebowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lindsay Scharfstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johnna Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eli R. Lebowitz.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lebowitz, E.R., Scharfstein, L. & Jones, J. Child-Report of Family Accommodation in Pediatric Anxiety Disorders: Comparison and Integration with Mother-Report. Child Psychiatry Hum Dev 46, 501–511 (2015). https://doi.org/10.1007/s10578-014-0491-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-014-0491-1

Keywords

Search

Navigation